Genomic Medicine

The Sorcerer's New Broom? the Limitations of the Human Genome Project

Published in: Western Journal of Medicine, v. 175, Dec. 2001, p. 424-426

Posted on RAND.org on December 31, 2000

by Ian D. Coulter

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Many believe that the human genome project will transform the way contemporary medicine is practiced, leading to disease being redefined in terms of biological or biochemical events. This paradigm shift, in turn, may help physicians diagnose and ultimately treat patients using gene therapy, aided by new drugs that target a patient's specific genetic profile. Despite the achievements of genomic medicine, evidence of its limitations is accumulating. Perhaps the most negative effect of the human genome project might come in its diversion of resources, scientists, and physicians from other promising medical paradigms. In his commentary, the author reviews the crisis in biomedicine, the dominant paradigm in the twentieth century, out of which have emerged four trends in medicine: the re-emergence of a holistic paradigm, Engel's biopsychosocial paradigm, phenomenology, and humanistic medicine. These movements share a dissatisfaction with biomedicine and a feeling that its reductionism and emphasis on technology have diminished both medicine and the patient and resulted in uncontrollable costs. The author warns that genomic medicine runs the risk of diverting the attention of medicine away from what the public and its critics have been saying, at a time when it seems as if medicine was adopting a more holistic paradigm. He cautions that the seduction of genomic medicine might blind the medical profession to the message that medicine is about people, not genes.

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